Translate this page into:
Prevalence of Obesity Among High School Children in Dakshina Kannada and Udupi Districts
Correspondence Keerthan Kumar M. Intern, K. S. Hegde Medical Academy, Nitte University Mangalore - 575 018, India. E-mail: keerthanupadhya@gmail.com
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Objective
The aim of this project is to find out the prevalence of overweight and obesity in the high school children in selected schools of Mangalore and Manipal and also to study the association of obesity with different factors like Age, Sex, Physical activity etc.
Methods
Cross sectional Study which included 500 participants from 10 selected schools in Udupi and D.K districts. 50 students were rd included from each school on the basis of 1 in 5 choosing every 3rd student. In schools with lesser attendance all were included. Following which they were explained the details about the study. Then their height and weight were recorded using standard measurements and the data was collected using the questionnaire.
Results
The overall prevalence of obesity and overweight was found to be 2.6% and 3.0% respectively. Prevalence was found to be higher in males, those studying in private schools, staying in nuclear family, consuming fried foods-aerated drinks regularly and in those who do not exercise regularly.
Conclusions
Childhood obesity is a major public health problem globally because of changes in lifestyle.
Keywords
BMI
exercise
unhealthy food
education
school
Introduction
Childhood obesity is one of the most serious public health challenges of the 21st century 1, 2. The problem is global and is steadily affecting many low-and middle-income countries, particularly in urban settings 3, 4. The prevalence has increased at an alarming rate. Globally in 2010 the number of overweight children under the age of five is estimated to be over 42 million. Close to 35 million of these are living in developing countries.5 Overweight and obesity are the fifth leading risk for global deaths. Overweight and obesity are linked to more death compared to malnutrition. The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been an increased intake of energy-dense foods that are high in fat, salt and sugars and a decrease in physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization6, 7, 8. Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education9.
Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, and early markers of cardiovascular disease, insulin resistance and psychological effects10.
In India there is paucity of data on the prevalence of childhood obesity which is an emerging health challenge. Therefore we decided to contribute to the data collection by investigating the prevalence of obesity in high school children in various schools in and around Mangalore and Manipal. This will help us in estimating the local prevalence of this condition and will prepare us for the challenge of introducing primary prevention in this area. Habit formation occurs mainly during childhood and adolescence. So primary interventions targeting this age group has high possibility of yielding good results. This is the reason why we have targeted this age group of 1216years. Thus the aim of this project is to find out the prevalence of overweight and obesity in the high school children in selected schools of Mangalore and Manipal and also to study the association of obesity with different factors like Age, Sex, Physical activity etc. Materials and Methods
The study duration was for: 2 months (July-August-2011). Personal interviews and observations were done Questionnaires were distributed and weight measurement by weighing scale and height by standard methods.
10 schools across different places in the selected area, of which 5 were government schools and 5 were private schools. The sample size was 500 students.
Male and female students of grades 8th to 10th are included in the study without considering the proportionality of their distribution. We asked 10 schools across the study area for permission allowing us to conduct our study on their students. From the hundreds of schools spread across this large area of study we selected schools for the study according to our convenience. There was no mechanism for randomization in place. Consent forms were signed by the head of the institutions. Once consent was obtained the data was collected from students.
50 students were included from each school on the basis of 1 in 5 choosing every 3rd student, in schools with lesser attendance all were included. Following which they were explained the details about the study. Then their height and weight were recorded using standard measurements and the data was collected using the questionnaire. The data collected was collated using Excel spreadsheets with double checking of errors. The results were assembled in tabular and graphical formats and statistical analysis was dome through chi square
Results
We assessed the prevalence of overweight and obesity and associated factors, in urban and rural school children in Mangalore and Udupi districts in a cross sectional study of 500 school children aged 12-15 years. The prevalence of obesity and overweight was 2.6% and 3.0% (table-1). The prevalence of obesity and overweight was found to be higher in males (table-2). Prevalence of Obesity (4.51%) was found to be higher in children's studying in private schools as compared to government school (1.28%) but the prevalence of overweight was found to be higher in government school children.(table-3)The percentage of Overweight (3.11%) and Obesity (4.15%) is much higher in children's staying in nuclear family than joint family (1.89% and 1.42%)(table-4). The percentage is high in those who don't exercise regularly (3.2% and 4.51%) as compared to those who exercise regularly (2.31% and 1.77%)and in those who exercise for less than 2hrs in a day (3.21% and 3.92%)(table-5A 5B).
| Age(yrs) | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(Kg) | Total |
|---|---|---|---|---|---|
| 12 | 51 (74.0%) | 16 (23.0%) | 1 (1.5%) | 1 (1.5%) | 69 |
| 13 | 69 (57.0%) | 47 (39.0%) | 2 (1.6%) | 3 (2.4%) | 121 |
| 14 | 92 (59.0%) | 57 (37.0%) | 2 (1.0%) | 5 (3.0%) | 156 |
| 15 | 72 (47.0%) | 68 (44.0%) | 8 (5.0%) | 6 (4.0%) | 154 |
| Total | 284(56.8%) | 188(37.6%) | 13(2.6%) | 15(3%) | 500 |
| Sex | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Male | 133 (61.0%) | 71 (33.0%) | 8 (3.7%) | 5 (2.3%) | 217 |
| Female | 151(53.4%) | 117(41.3%) | 5 (1.8%) | 10(3.5% ) | 283 |
| Total | 284 (56.8%) | 188(37.6%) | 13 (2.6%) | 15(3.0%) | 500 |
| Type of School | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese (kg) | Total |
|---|---|---|---|---|---|
| Private | 124(47.0%) | 128(48.0%) | 2(0.75%) | 12(4.5%) | 266(53.2%) |
| Govt. | 160(68.4%) | 60(25.6%) | 11 (4.7% ) | 3 (1.3%) | 234(46.8%) |
| Total | 284(56.8%) | 188(37.6%) | 13(2.6%) | 15(3.0%) | 500 (100%) |
| Type of family | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Nuclear | 161(56.0%) | 107(37.0%) | 9 (3.0%) | 12(4.0%) | 289(57.8%) |
| Joint | 123(58.0%) | 81 (38.0%) | 4 (2.0%) | 3 (2.0%) | 211(42.2%) |
| Total | 284(56.8%) | 188(37.6%) | 13(2.6%) | 15(3.0%) | 500(100%) |
| Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total | ||
|---|---|---|---|---|---|---|
| Regular | Yes | 150(53.0%) | 120(43.0%) | 6 (2.0%) | 5 (2.0%) | 281 |
| No | 134(61.0%) | 68 (31.0%) | 7 (3.0%) | 10(5.0%) | 219 |
| Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total | |
|---|---|---|---|---|---|
| Mild | 160(58.0%) | 98(35.0%) | 10(4.0%) | 9(3.0%) | 277(55.4%) |
| moderate | 100(64.0%) | 50(32.0%) | 2(1.4%) | 4(2.6%) | 156(31.2%) |
| heavy | 24(35.0%) | 40(60.0%) | 1(2.0%) | 2(3.0%) | 67(13.4%) |
The percentage is much higher in those who consume pastries, fried food regularly (4.88% and 4.44%) as compared to those who don't consume these regularly (0.72 and 1.81%)(table-6, 7).
| Consumption of aerated drinks | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Yes | 124(54.0%) | 89(39.0%) | 7(3.0%) | 9(4.0%) | 229(46%) |
| No | 160(59.0%) | 99(37.0%) | 6(2.0%) | 6(2.0%) | 271(54%) |
| Total | 284(56.8%) | 188(37.6%) | 13(2.6%) | 15(3.0%) | 500(100%) |
| History of consumption | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Regular | 104(46.3%) | 100(44.4%) | 11(4.9%) | 10(4.4%) | 225(45%) |
| Occasional | 180(65.4%) | 88 (32.0%) | 2 (0.8%) | 5(1.8%) | 275(55%) |
Discussion
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.
BMI is a simple index of weight for height that is commonly used to classify overweight and obesity in adults. It is defined as person's weight in kilograms divided by square of height in meters. The WHO definition mentions that BMI is greater than or equal to 25 – overweight, BMI greater than or equal to 30 – obesity. Although WHO defines overweight & obesity as stated above, we have used the definitions for the Indian population, as stated in the NFI (National Foundation of India) Bulletin, Vol 26, No 4.
The definition for Indian population, used for the study was that BMI greater than or equal to 23 – overweight, and BMI greater than or equal to 25 – obesity
Severity of exercise based on duration was labelled MILD: equal to less than 30 minutes. MODERATE: 1 to 2 hours (sweating) HEAVY: more than 3 hours (On at least 5 days in a week is taken as regular exercise for this study). For TV viewing, more than 2 hrs. per day was taken as regular TV viewing for the purpose of this study. Energy dense food intake was defined as high energy food like energy drinks, fruit juices, pastries, fried food that is rich in sugars and saturated fat. Regular consumption: if consumed more than 4 times a week.
| Males | 217(43%) |
|---|---|
| Females | 283(57%) |
| Total | 500(100%) |
| 12 | 148(30%) |
|---|---|
| 13 | 132(26%) |
| 14 | 160(32%) |
| 15 | 60(12%) |
| Total | 500(100%) |
There is a positive co-relation between Age and Obesity. The Prevalence of overweight (5.2%) and obesity (3.89%) is highest in 15yr age group and we also found that as age advances there is a significant increase in the prevalence of obesity.(Table 1 Graph 1).
No significant association was found between sex of school children and obesity; however the overall prevalence of overweight and obesity was found to be higher in females (Tables 2 graph 2).
There is a positive co-relation between Type of school and obesity. The Prevalence of Obesity (4.51%) was found to be higher in children studying in private schools as compared to government schools (1.28%) but the prevalence of overweight was found to be higher in government school children (4.70%) as compared to private schools (0.70%) (Table 3 Graph 3)
No significant association was found between type of family the student's live in with obesity according to p-value but the percentage of Overweight (3.11%) and Obesity(4.15%) is much higher in children's staying in nuclear family than joint family(1.89% and 1.42%)(table 4 graph 4). Regular physical activity is inversely related to obesity. The percentage is high in those who don't exercise regularly (3.2% and 4.51%) as compared to those who exercise regularly (2.31% and 1.77%) and in those who exercise for less than 2 hrs. a day(3.21% and 3.92%) (Table 5a, 5b Graph-5a, 5b).
There is a positive co-relationship between overweight and obesity with the consumption of fried foods, energy drinks, pastries and fruit juices regularly as the percentage is much higher in these(4.88% and 4.44%) compared to those who don't consume these regularly(0.72 and 1.81%). (Table 6, 7 Graph 6, 7).
There is no significant association between obesity and TV viewing (>2hrs) and children's who get Tiffin from home, however it was found that the prevalence of overweight and obesity is much higher in children who don't get Tiffin from home (4.02% and 3.51%)as compared to those who get Tiffin from home (1.66% and 2.65%).(Table 8, 9 Graph 8, 9).
| TV viewing | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Yes | 150(52.0%) | 120(42.0%) | 10(3.2%) | 8 (2.8%) | 288(58%) |
| No | 134(63.0%) | 68 (32.0%) | 3 (1.0%) | 7 (4.0%) | 212(42%) |
| Total | 284(56.8%) | 188(37.6%) | 13(2.6%) | 15(3.0%) | 500(100%) |
| Tiffin from home | Under weight(kg) | Normal weight(kg) | Over weight(kg) | Obese(kg) | Total |
|---|---|---|---|---|---|
| Yes | 180(60.0%) | 108(36.0%) | 5(1.0%) | 8 (2.0%) | 301(60.0%) |
| No | 104(52.0%) | 80(40.0%) | 8(4.0%) | 7 (4.0%) | 199(40.0%) |
| Total | 284(57.0%) | 188(38.0%) | 13(3.0%) | 15(3.0%) | 500(100%) |
Conclusion
From the data we have collected we conclude that regular exercise, more than 5 days a week, plays a major role in combating overweight and obesity, and should hence be encouraged. Since TV viewing of more than 2 hrs a day, is a major culprit for childhood obesity, parents and teachers should be advised to engage children in outdoor games and healthy activities. Children carrying tiffin from home, tend to be leaner and hence healthier, as they refrain from eating unhealthy food from out. Hence parents should be advised to take a genuine effort to play a major role in their children's health. Elders-parents and teachers are advised to educate children about the ill effects of aerated drinks and energy dense food.
References
- “Prevalence of overweight and obesity in the United States, 1999-2004”. JAMA. 2006;295((13)):1549-55.
- [Google Scholar]
- “Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns” Obesity Review. . 2005;6((2)):123-32.
- [Google Scholar]
- “Prevalence of overweight and obesity and associated risk factors in urban primary school children in Babol, Islamic Republic of I ran”. East Mediterranean health journal. 2011;17((2)):109-14.
- [Google Scholar]
- “Prevalence of Overweight and Obesity in Relation to Socio-economic Conditions in Two Different Groups of School-age Children of Udaipur City” (Rajasthan). Journal, Indian Academy of Clinical Medicine. 2006;7((2)):133-5.
- [Google Scholar]
- “Prevalence of overweight in urban Indian adolescent school children”. Diabetes Research and Clinical Practice.. 2002;57((3)):185-90.
- [Google Scholar]
- “Simple obesity in children. a study on the role of nutritional factors”. Med wieku Rozwoj. 2006;10((1)):3-191.
- [Google Scholar]
- “Prevalence of overweight and obesity among adolescents in Irbid governorate, Jordan”. East Mediterranean Health journal.. 2010;16((6)):657-62.
- [Google Scholar]
- “Overweight and obesity their correlates among Jordanian adolescents”. Journal Nurs Scholarsh.. 2010;42((4)):387-94.
- [Google Scholar]
- “Prevalence of overweight and obesity in Indian adolescent school going children:its relationship with socioeconomic status and associated life style factors”; Journal assoc physicians India. . 2010;58:151-8.
- [Google Scholar]
- “Obesity in Indian children: time trends and relationship with hypertension”. Natl Med J India.. 2007;20((6)):288-93.
- [Google Scholar]
- “Parenthood -a contributory factor to childhood obesity”. International journal of environmental Research and public health.. 2010;7((7)):2800-1.
- [Google Scholar]
- “Growth pattern and prevalence of obesity in affluent schoolchildren of Delhi”. Public Health Nutrition journal. 2007;10((5)):485-91.
- [Google Scholar]
- “Social and economic consequences of overweight in adolescence and young adulthood”. N Engl J Med. 1993 Sep
- [Google Scholar]
- “Obesity among preadolescent and adolescents of a developing country(india)”. Asia Pac journal of clinical nutrition (2004)
- [Google Scholar]
- “Influence of parental obesity on school children”. Indian journal of pediatrics 2010 march
- [Google Scholar]
- “Global epidemics of childhood obesity is hitting a “less industrialized” corner in Asia: a case study in Macao”;. International journal of pediatric obesity. 2011;6((2-2)):e252-6.
- [Google Scholar]
- “Study of childhood obesity among school children aged 6-12 years in union territory of puducherry”;. Indian journal community medicine. 2011;36((1)):45-50.
- [Google Scholar]